Obamacare Abortion Resources
How do I use this site?
This site is designed to help you determine if a health insurance plan covers elective abortion before you decide which plan to select. To find out if a health insurance plan covers elective abortion, visit the homepage then click on your state on the interactive map. After clicking on your state, a summary of all the insurance carriers offering individual and family plans on your state (or federally-facilitated) exchange will appear. The page identifies each of the offered exchange plans in your state, and whether or not those plans cover elective abortion.
If you find an insurance carrier marked “Unknown,” this means that we have searched their publicly available online documents and contacted them, but still have no clear information about their coverage. We encourage you to contact us at firstname.lastname@example.org if you find any additional or conflicting information regarding the abortion coverage policy of your plan.
You can also find state-specific related news articles on Obamacare and abortion coverage abortion coverage below your state summary.
How does Obamacare subsidize and promote insurance coverage of abortion?
Obamacare created a premium assistance credit program to help people in certain income ranges purchase insurance. This program was estimated to cost $855 billion in taxpayer dollars by 2024, according to the Congressional Budget Office’s April 2014 estimate of total costs from 2015 through 2024. However, a more recent Congressional Budget report from 2018-2028 projects a total of $703 billion in taxpayer dollars going to subsidize insurance coverage of abortion. This is likely to due more states have opted out of participating in abortion coverage, less people choosing to enroll through obamacare, and the removal of the Individual Mandate tax penalty to take effect in 2019.
Under Obamacare, insurance plans sold on the exchanges can be purchased with federal subsidies even if the subsidized plan includes elective abortion. Efforts to prevent this unfortunate outcome were thwarted when the Stupak-Pitts amendment to Obamacare was removed from the legislation before it passed in 2010.
Obamacare also promotes insurance coverage of abortion on demand through the following avenue: Medicaid expansion and the “preventive services mandate” that requires coverage of some abortion-inducing drugs. Here are some additional resources explaining abortion funding in Obamacare:
- “Issue Analysis: Abortion Funding and Obamacare” (June 2016)
- “Taxpayer-Funding of Abortion in Obamacare” (Jan. 2014)
- “Multi-State Plans: A Potential Avenue to Tens of Thousands of Publicly Subsidized Abortions” (Sept. 2013)
Additionally, the Obama administration awarded over $655,000 in taxpayer grants in 2013 to the nation’s largest abortion provider, Planned Parenthood, so that its employees could act as “navigators” in assisting consumers purchasing health insurance.
What is a Multi-State Plan (MSP) and why do these plans matter?
A multi-state plan (MSP) is a health insurance plan issued by a private carrier that is under contract with the federal government’s Office of Personnel Management (OPM). Under Obamacare, OPM is required to establish a network of multi-state plans with at least two plans offered on each state exchange. Obamacare only requires OPM to ensure that one multi-state plan in each state does not include elective abortion coverage. There is no prohibition on abortion coverage in other plans, unless a state itself has enacted legislation barring such coverage from insurance plans.
Because Obamacare requires that MSPs be phased in gradually over a four-year period ending in 2017, the states that do not yet have MSPs or a state law barring elective abortion from the exchange may not have any plan available for purchase that excludes elective abortion through the exchange. According to the 2014 report by the Government Accountability Office (GAO), this lack of any alternative to a plan offering abortion on demand affected Americans in five states: Connecticut, Hawaii, New Jersey, Rhode Island, and Vermont.
In 2015, Connecticut was added to the Multi-State Plan Program, and introduced new MSPs that did not cover abortion on demand.
In 2016, Rhode Island and New Jersey added new plans that excluded elective abortion from coverage.
How many states have Multi-State Plans (MSPs)?
For the 2019 enrollment year, Arkansas is the only state offering MSPs through Arkansas Blue Cross Blue Shield. Neither of the two MSPs in Arkansas cover elective abortion.
In 2018, MSP options were only offered throughout the State of Arkansas by Arkansas Blue Cross Blue Shield.
In 2017, 22 states offered Multi-State Plans, down from 32 states and the District of Columbia in 2016. Obamacare required that MSPs be available in every state by 2017.
Where can I find more information about plans that cover abortion-inducing drugs and devices?
If you are viewing plans on your state exchanges, you may see a link to other detailed documents, in particular, a drug formulary. This lists each drug that the plan covers. If it is not provided on the exchange, you may find the formulary on the insurance carrier’s own website.
Plan documents may state that abortion-inducing or “abortifacient” drugs are excluded from coverage; however, this can be misleading. The criteria the Food and Drug Administration (FDA) uses for labeling drugs as an abortifacient are limited to instances where a new life has already implanted in the uterus and is dislodged and do not include when the drug may prevent an already fertilized egg from implanting in the uterus. That is, the egg and sperm have already united, forming a genetically distinct and unique being, but the drug prevents its implantation, causing it to die.
For more information on how emergency contraceptives can have abortion-inducing mechanisms of action (MOA), please visit:
- Abortifacients - Life Issues Institute
- New Studies Show All Emergency Contraceptives Can Cause Early Abortion - Charlotte Lozier Institute (Jan. 2014)
- Full Disclosure: Blurry or Broken Language and the Beginning of Human Life - Charlotte Lozier Institute (Nov. 2013)
I thought that no federal tax dollars could be used for abortion?
In 2009, President Obama told a joint session of Congress that “under our plan, no federal dollars will be used to fund abortion.”He signed an Executive Order in March 2010 promising this result but he did not include all of the language from the proposed Stupak-Pitts amendment, which would have prohibited federal funds from covering abortion or any costs of any health plan that covers abortion. As implemented, the premium tax credits established by Obamacare may be used to subsidize the costs of health care plans that cover abortion, and the GAO found that in 2014 a total of 1,036 insurance plans that cover elective abortion were available for purchase with federal subsidies on the health care exchanges. Moreover, senior Obama administration officials acknowledge that the Executive Order was simply utilized to pass Obamacare, and that it is non-binding and revocable.
I thought health care plans were supposed to keep money for abortion separate from other premiums?
Obamacare allows elective abortion coverage to be included in the health insurance package purchased with federal subsidies. It simultaneously requires a separate abortion surcharge that health insurance companies are to collect from insured individuals and families and deposit in a fund to be used to pay for elective abortions. This scheme represents a complete departure from the longstanding principle found in the Hyde amendment and governing other federally subsidized health programs – that no federal dollars go toward a health plan that includes elective abortion.
Obamacare created a billing arrangement to supposedly keep federal dollars from going toward abortion coverage, but this arrangement is largely inoperative. The segregation of funds provision requires that two “separate” payments be collected -one for the general monthly premium and a second surcharge to be used exclusively for abortion on demand - but the GAO report found in September 2014 the administration reinterpreted this billing arrangement for plans sold in 2014.
Instead of requiring the two separate payments, the Department of Health and Human Services told insurance issuers to simply itemize the abortion surcharge. GAO found that, in fact, none of the issuers interviewed for that report billed abortion separately or itemized the abortion surcharge. One issuer reported to GAO that it did not even know about the requirement to file an abortion segregation plan with its state department of health insurance.
Taxpayer dollars are still free to flow to plans that cover abortion. Because Americans cannot consistently determine whether their plan includes abortion on demand, they may be paying an invisible abortion surcharge without even knowing it. Even if they are not buying such a plan themselves, billions of dollars in tax subsidies are flowing under Obamacare to plans that do cover elective abortion.
Are any health care plans actually using segregated accounts for abortion premiums?
For 2014, according to the GAO report, none of the entities interviewed that billed insurance for qualified health plans on the exchanges either itemized abortion on the premium bill or issued a separate bill that clearly named its purpose for abortion. We will update this section for 2019 as we receive new information.
How has the Department of Health and Human Services (HHS) responded to concerns about abortion coverage in health care plans?
In October of 2013, Rep. John Shimkus (Illinois) asked former HHS Secretary Kathleen Sebelius to provide a list of the insurers in the exchange that exclude abortion. She responded, “I think we can do that;” however, she did not provide any list.
In December of 2013, Rep. Shimkus again questioned former Secretary Sebelius about the continued lack of abortion insurance transparency. She responded that consumers should check the Summaries of Benefits and Coverage (SBC), saying, “It is available”; however, as of the date of this writing (November 2014), most SBCs still did not include abortion coverage information.
In March of 2014, Rep. Andy Harris (MD) asked former HHS Secretary Sebelius if abortion coverage should be transparent and to clarify whether the abortion surcharge is required to be separate. She responded by shifting blame to the states about their interpretation of the billing procedures, though her role as Secretary of HHS requires her to exercise broad oversight of even state exchanges.
In August of 2014, Rep. Diane Black (TN) and other Members of Congress sent a letter asking the Department for detailed information about compliance with the abortion rules in Obamacare. There has been no response.
In October of 2014, new HHS Secretary Sylvia Burwell was asked whether insurance plans would be more transparent about abortion coverage for the 2015 enrollment period. She said, “We’ll have to see.”
In October 2017, HHS released a bulletin detailing the restrictions and greater enforcement of Section 1303 of the Patient Protection and Affordable Care Act beginning in plan year 2018. Under Section 1303, prohibits the use of certain Federal funds to pay for elective abortions, requires qualified health issuers to provide notice of elective abortion coverage through their plan summary of benefits and coverage explanations at the time of enrollment, and that issuers must segregate funds for elective abortion services collected from enrollees.
On November 9, 2018 HHS issued a proposed rule called the Patient Protection and Affordable Care Act; Exchange Program Integrity meant to “propose new requirements for certain issuers related to the collection of a separate payment for the premium portion attributable to coverage for certain abortion services.” If this rule is finalized issuers would be required to: Send an entirely separate monthly bill to the consumer for only the portion of the premium that covers abortion, and instruct the enrollee to pay the portion of their premium that covers abortion in a separate transaction from the payment of the premium that does not cover abortion.
Are there any options besides purchasing an Obamacare health insurance plan?
Because of the individual mandate in Obamacare, Americans were required to purchase health coverage, or pay a tax penalty. Due to the passage of the Tax Cuts and Jobs Act of 2017 the individual mandate will no longer exist starting with the 2019 plan year. However Massachusetts, New Jersey, and the District of Columbia have all the imposed their own state mandates effective 2019. Vermont’s mandate will be effective for 2020 enrollment. Other states are also considering implementing their own individual mandates.
For more information, please visit this healthcare.gov link.
If you are dissatisfied with your state insurance choices, you may consider a healthcare sharing ministry. While healthcare sharing does not fix the problem of abortion funding in Obamacare, it does provide an option that respects conscience and moral values. These ministries do not provide insurance as defined by law, but rather operate on a system of voluntary contributions to share medical costs among their members. Healthcare sharing ministries are exempt from the individual mandate of Obamacare. These healthcare sharing ministries do not support abortion in any way and provide an alternative to the state and federal exchanges. For more information on healthcare sharing, please visit the below resources:
Two legislative bills have been introduced to fix Obamacare’s abortion funding and lack of transparency, namely the No Taxpayer Funding for Abortion and the Abortion Insurance Full Disclosure Act of 2014 (H.R. 7) and the Abortion Insurance Full Disclosure Act of 2013 (H.R. 3279). H.R. 7 was sponsored by U.S. Rep. Chris Smith (R-NJ) and Rep. Dan Lipinski (D-IL) and passed the House of Representatives in 2013 with bipartisan support. The Senate version of the bill is S. 946, introduced by Roger Wicker (R-MS). The Senate has not voted on this bill since its introduction in 2013.
For 2015, the No Taxpayer Funding for Abortion and Abortion Full Disclosure Act (collectively H.R. 7), was reintroduced in the House of Representatives by Rep. Chris Smith on January 21, 2015. On January 22, the day of the March for Life and the 42nd anniversary of the passage of Supreme Court decision Roe v. Wade, the House passed H.R. 7. The Senate version was re-introduced as S. 582 by Sen. Wicker for the new Congress on February 26, 2015. It has not yet been voted on as of March 19, 2015. The No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2017 (H.R. 7) passed the House in January 2017 and awaiting pickup in the Senate.
Other Key Documents:
HEALTH INSURANCE EXCHANGES: Coverage of Non-excepted Abortion Services by Qualified Health Plans, published September 15, 2014 by the Government Accountability Office (GAO)